=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689526659
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MCCULLOUGH MEDICAL PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2026
-----------------------------------------------------
Last Update Date | 02/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2501 KENTUCKY AVE FL 5
-----------------------------------------------------
City | PADUCAH
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42003-3813
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-217-8482
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 265 BILLY WATKINS RD
-----------------------------------------------------
City | BENTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42025-7468
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-703-0018
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | STEVEN MCCULLOUGH
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 270-703-0018
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------